Active NPI
Kenneth M Hodge, MD
- Otolaryngology Physician
- Louisville, KY
National Provider Identifier
1750388286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 22157
- Practice address
- 2944 Breckenridge LN
Louisville, KY 40220-1409 - Phone
- (502) 893-0159
- NPI assigned
- Jun 30, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Oncology Physician | 207RX0202X | 01040152A | IN | |
| Medical Oncology Physician | 207RX0202X | 22157 | KY | |
| Otolaryngology Physician | 207Y00000X | 01040152A | IN | |
| Otolaryngology Physician | 207Y00000X | 22157 | KY | Primary |
Addresses
Primary practice location
2944 Breckenridge LN
Louisville, KY 40220-1409
Mailing address
2944 Breckenridge LN
Louisville, KY 40220-1409
Phone (502) 893-0159
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64221575 | Medicaid | KY | |
| 040003868 | Other | KY | MEDICARE RR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- University of Louisville School of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
108 W Daisy LN
New Albany, IN 47150-4537
Phone 50289301591188
2944 Breckenridge LN
Louisville, KY 40220-1409
Phone 50289301591188
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.34 of 100
- Quality
- 89.81
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040152A | IN | MD | Medical Oncology Physician |
| 22157 | KY | MD | Medical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Merit Anesthesia PLLC | Current | Accepting new patients | |
| Commonwealth Ear Nose & Throat-Head & Neck Center | Otolaryngology | Past | Accepting new patients |
Locations
108 W Daisy Ln
New Albany, IN 47150
Phone (812) 945-3557
2944 Breckenridge Ln
Louisville, KY 40220
Phone (502) 995-5525
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Knoxville, TN
- NPI 1366624967
-
- Otolaryngology Physician
- Carol Stream, IL
- NPI 1689732836
Hospital & facility affiliations 15
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1265539498
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1043348808
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1447388335
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1699514463
-
- General Acute Care Hospital
- Louisville, KY
- NPI 1831195908
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668470400000",
"number": "1750388286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2944 BRECKENRIDGE LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402201409",
"telephone_number": "502-893-0159",
"fax_number": "502-213-3853"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2944 BRECKENRIDGE LN",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402201409",
"telephone_number": "502-893-0159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "KENNETH",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-30",
"last_updated": "2022-11-15",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "IN",
"license": "01040152A",
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "KY",
"license": "22157",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "IN",
"license": "01040152A",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "KY",
"license": "22157",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64221575",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "040003868",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.